The orbitofrontal cortex functionally links obesity and white matter hyperintensities

Many studies have linked dysfunction in cognitive control-related brain regions with obesity and the burden of white matter hyperintensities (WMHs). This study aimed to explore how functional connectivity differences in the brain are associated with WMH burden and degree of obesity using resting-state functional magnetic resonance imaging (fMRI) in 182 participants. Functional connectivity measures were compared among four different groups: (1) low WMH burden, non-obese; (2) low WMH burden, obese; (3) high WMH burden, non-obese; and (4) high WMH burden, obese. At a large-scale network-level, no networks showed significant interaction effects, but the frontoparietal network showed a main effect of degree of obesity. At a finer node level, the orbitofrontal cortex showed interaction effects between periventricular WMH burden and degree of obesity. Higher functional connectivity was observed when the periventricular WMH burden and degree of obesity were both high. These results indicate that the functional connectivity of the orbitofrontal cortex is affected by the mutual interaction between the periventricular WMHs and degree of obesity. Our results suggest that this region links obesity with WMHs in terms of functional connectivity.

Marginal radiomics features as imaging biomarkers for pathological invasion in lung adenocarcinoma

OBJECTIVES

Lung adenocarcinomas which manifest as ground-glass nodules (GGNs) have different degrees of pathological invasion and differentiating among them is critical for treatment. Our goal was to evaluate the addition of marginal features to a baseline radiomics model on computed tomography (CT) images to predict the degree of pathologic invasiveness.

METHODS

We identified 236 patients from two cohorts (training, n = 189; validation, n = 47) who underwent surgery for GGNs. All GGNs were pathologically confirmed as adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA). The regions of interest were semi-automatically annotated and 40 radiomics features were computed. We selected features using L1-norm regularization to build the baseline radiomics model. Additional marginal features were developed using the cumulative distribution function (CDF) of intratumoral intensities. An improved model was built combining the baseline model with CDF features. Three classifiers were tested for both models.

RESULTS

The baseline radiomics model included five features and resulted in an average area under the curve (AUC) of 0.8419 (training) and 0.9142 (validation) for the three classifiers. The second model, with the additional marginal features, resulted in AUCs of 0.8560 (training) and 0.9581 (validation). All three classifiers performed better with the added features. The support vector machine showed the most performance improvement (AUC improvement = 0.0790) and the best performance was achieved by the logistic classifier (validation AUC = 0.9825).

CONCLUSION

Our novel marginal features, when combined with a baseline radiomics model, can help differentiate IA from AIS and MIA on preoperative CT scans.

KEY POINTS

• Our novel marginal features could improve the existing radiomics model to predict the degree of pathologic invasiveness in lung adenocarcinoma.

Joint-Connectivity-Based Sparse Canonical Correlation Analysis of Imaging Genetics for Detecting Biomarkers of Parkinson's Disease

Imaging genetics is a method used to detect associations between imaging and genetic variables. Some researchers have used sparse canonical correlation analysis (SCCA) for imaging genetics. This study was conducted to improve the efficiency and interpretability of SCCA. We propose a connectivity-based penalty for incorporating biological prior information. Our proposed approach, named joint connectivity-based SCCA (JCB-SCCA), includes the proposed penalty and can handle multi-modal neuroimaging datasets. Different neuroimaging techniques provide distinct information on the brain and have been used to investigate various neurological disorders, including Parkinson's disease (PD). We applied our algorithm to simulated and real imaging genetics datasets for performance evaluation. Our algorithm was able to select important features in a more robust manner compared with other multivariate methods. The algorithm revealed promising features of single-nucleotide polymorphisms and brain regions related to PD by using a real imaging genetic dataset. The proposed imaging genetics model can be used to improve clinical diagnosis in the form of novel potential biomarkers. We hope to apply our algorithm to cohorts such as Alzheimer's patients or healthy subjects to determine the generalizability of our algorithm.

Two-step deep neural network for segmentation of deep white matter hyperintensities in migraineurs

BACKGROUND AND OBJECTIVE

Patients with migraine show an increased presence of white matter hyperintensities (WMHs), especially deep WMHs. Segmentation of small, deep WMHs is a critical issue in managing migraine care. Here, we aim to develop a novel approach to segmenting deep WMHs using deep neural networks based on the U-Net.

METHODS

148 non-elderly subjects with migraine were recruited for this study. Our model consists of two networks: the first identifies potential deep WMH candidates, and the second reduces the false positives within the candidates. The first network for initial segmentation includes four down-sampling layers and four up-sampling layers to sort the candidates. The second network for false positive reduction uses a smaller field-of-view and depth than the first network to increase utilization of local information.

RESULTS

Our proposed model segments deep WMHs with a high true positive rate of 0.88, a low false discovery rate of 0.13, and F₁ score of 0.88 tested with ten-fold cross-validation. Our model was automatic and performed better than existing models based on conventional machine learning.

CONCLUSION

We developed a novel segmentation framework tailored for deep WMHs using U-Net. Our algorithm is open-access to promote future research in quantifying deep WMHs and might contribute to the effective management of WMHs in migraineurs.

Geographic atrophy segmentation in SD-OCT images using synthesized fundus autofluorescence imaging

BACKGROUND AND OBJECTIVE

Accurate assessment of geographic atrophy (GA) is critical for diagnosis and therapy of non-exudative age-related macular degeneration (AMD). Herein, we propose a novel GA segmentation framework for spectral-domain optical coherence tomography (SD-OCT) images that employs synthesized fundus autofluorescence (FAF) images.

METHODS

An en-face OCT image is created via the restricted sub-volume projection of three-dimensional OCT data. A GA region-aware conditional generative adversarial network is employed to generate a plausible FAF image from the en-face OCT image. The network balances the consistency between the entire synthesize FAF image and the lesion. We use a fully convolutional deep network architecture to segment the GA region using the multimodal images, where the features of the en-face OCT and synthesized FAF images are fused on the front-end of the network.

RESULTS

Experimental results for 56 SD-OCT scans with GA indicate that our synthesis algorithm can generate high-quality synthesized FAF images and that the proposed segmentation network achieves a dice similarity coefficient, an overlap ratio, and an absolute area difference of 87.2%, 77.9%, and 11.0%, respectively.

CONCLUSION

We report an automatic GA segmentation method utilizing synthesized FAF images.

SIGNIFICANCE

Our method is effective for multimodal segmentation of the GA region and can improve AMD treatment.

Synthesizing diffusion tensor imaging from functional MRI using fully convolutional networks

PURPOSE

Medical image synthesis can simulate a target modality of interest based on existing modalities and has the potential to save scanning time while contributing to efficient data collection. This study proposed a three-dimensional (3D) deep learning architecture based on a fully convolutional network (FCN) to synthesize diffusion-tensor imaging (DTI) from resting-state functional magnetic resonance imaging (fMRI).

METHODS

fMRI signals derived from white matter (WM) exist and can be used for assessing WM alterations. We constructed an initial functional correlation tensor image using the correlation patterns of adjacent fMRI voxels as one input to the FCN. We considered T1-weighted images as an additional input to provide an algorithm with the structural information needed to synthesize DTI. Our architecture was trained and tested using a large-scale open database dataset (training n = 648; testing n = 293).

RESULTS

The average correlation value between synthesized and actual diffusion tensors for 38 WM regions was 0.808, which significantly improves upon an existing study (r = 0.480). We also validated our approach using two open databases. Our proposed method showed a higher correlation with the actual diffusion tensor than the conventional machine-learning method for many WM regions.

CONCLUSIONS

Our method synthesized DTI images from fMRI images using a 3D FCN architecture. We hope to expand our method of synthesizing various other imaging modalities from a single image source.

Clinical impact of variability on CT radiomics and suggestions for suitable feature selection: a focus on lung cancer

Background

Radiomics suffers from feature reproducibility. We studied the variability of radiomics features and the relationship of radiomics features with tumor size and shape to determine guidelines for optimal radiomics study.

Methods

We dealt with 260 lung nodules (180 for training, 80 for testing) limited to 2 cm or less. We quantified how voxel geometry (isotropic/anisotropic) and the number of histogram bins, factors commonly adjusted in multi-center studies, affect reproducibility. First, features showing high reproducibility between the original and isotropic transformed voxel settings were identified. Second, features showing high reproducibility in various binning settings were identified. Two hundred fifty-two features were computed and features with high intra-correlation coefficient were selected. Features that explained nodule status (benign/malignant) were retained using the least absolute shrinkage selector operator. Common features among different settings were identified, and the final features showing high reproducibility correlated with nodule status were identified. The identified features were used for the random forest classifier to validate the effectiveness of the features. The properties of the uncalculated feature were inspected to suggest a tentative guideline for radiomics studies.

Results

Nine features showing high reproducibility for both the original and isotropic voxel settings were selected and used to classify nodule status (AUC 0.659–0.697). Five features showing high reproducibility among different binning settings were selected and used in classification (AUC 0.729–0.748). Some texture features are likely to be successfully computed if a nodule was larger than 1000 mm³.

Conclusions

Features showing high reproducibility among different settings correlated with nodule status were identified.

Electronic supplementary material

The online version of this article (10.1186/s40644-019-0239-z) contains supplementary material, which is available to authorized users.

Possible links between the lag structure in visual cortex and visual streams using fMRI

Conventional functional connectivity analysis using functional magnetic resonance imaging (fMRI) measures the correlation of temporally synchronized brain activities between brain regions. Lag structure analysis relaxes the synchronicity constraint of fMRI signals, and thus, this approach might be better at explaining functional connectivity. However, the sources of the lag structure in fMRI are primarily unknown. Here, we applied lag structure analysis to the human visual cortex to identify the possible sources of lag structure. A total of 1,250 fMRI data from two independent databases were considered. We explored the temporal lag patterns between the central and peripheral visual fields in early visual cortex and those in two visual pathways of dorsal and ventral streams. We also compared the lag patterns with effective connectivity obtained with dynamic causal modeling. We found that the lag structure in early visual cortex flows from the central to peripheral visual fields and the order of the lag structure flow was consistent with the order of signal flows in visual pathways. The effective connectivity computed by dynamic causal modeling exhibited similar patterns with the lag structure results. This study suggests that signal flows in visual streams are possible sources of the lag structure in human visual cortex.

FuNP (Fusion of Neuroimaging Preprocessing) Pipelines: A Fully Automated Preprocessing Software for Functional Magnetic Resonance Imaging

The preprocessing of functional magnetic resonance imaging (fMRI) data is necessary to remove unwanted artifacts and transform the data into a standard format. There are several neuroimaging data processing tools that are widely used, such as SPM, AFNI, FSL, FreeSurfer, Workbench, and fMRIPrep. Different data preprocessing pipelines yield differing results, which might reduce the reproducibility of neuroimaging studies. Here, we developed a preprocessing pipeline for T1-weighted structural MRI and fMRI data by combining components of well-known software packages to fully incorporate recent developments in MRI preprocessing into a single coherent software package. The developed software, called FuNP (Fusion of Neuroimaging Preprocessing) pipelines, is fully automatic and provides both volume- and surface-based preprocessing pipelines with a user-friendly graphical interface. The reliability of the software was assessed by comparing resting-state networks (RSNs) obtained using FuNP with pre-defined RSNs using open research data (n = 90). The obtained RSNs were well-matched with the pre-defined RSNs, suggesting that the pipelines in FuNP are reliable. In addition, image quality metrics (IQMs) were calculated from the results of three different software packages (i.e., FuNP, FSL, and fMRIPrep) to compare the quality of the preprocessed data. We found that our FuNP outperformed other software in terms of temporal characteristics and artifacts removal. We validated our pipeline with independent local data (n = 28) in terms of IQMs. The IQMs of our local data were similar to those obtained from the open research data. The codes for FuNP are available online to help researchers.

Effectiveness of imaging genetics analysis to explain degree of depression in Parkinson's disease

Depression is one of the most common and important neuropsychiatric symptoms in Parkinson's disease and often becomes worse as Parkinson's disease progresses. However, the underlying mechanisms of depression in Parkinson's disease are not clear. The aim of our study was to find genetic features related to depression in Parkinson's disease using an imaging genetics approach and to construct an analytical model for predicting the degree of depression in Parkinson's disease. The neuroimaging and genotyping data were obtained from an openly accessible database. We computed imaging features through connectivity analysis derived from tractography of diffusion tensor imaging. The imaging features were used as intermediate phenotypes to identify genetic variants according to the imaging genetics approach. We then constructed a linear regression model using the genetic features from imaging genetics approach to describe clinical scores indicating the degree of depression. As a comparison, we constructed other models using imaging features and genetic features based on references to demonstrate the effectiveness of our imaging genetics model. The models were trained and tested in a five-fold cross-validation. The imaging genetics approach identified several brain regions and genes known to be involved in depression, with the potential to be used as meaningful biomarkers. Our proposed model using imaging genetic features predicted and explained the degree of depression in Parkinson's disease appropriately (adjusted R2 larger than 0.6 over five training folds) and with a lower error and higher correlation than with other models over five test folds.

Cerebrovascular reactivity as a determinant of deep white matter hyperintensities in migraine

OBJECTIVE

To evaluate the association between the cerebrovascular reactivity to carbon dioxide (CO₂-CVR) and the deep white matter hyperintensity (WMH) burden in patients with migraine.

METHODS

A total of 86 nonelderly patients with episodic migraine without vascular risk factors and 35 headache-free controls underwent 3T MRI. Deep WMHs were quantified with a segmentation method developed for nonelderly migraineurs. The interictal CO₂-CVR was measured with transcranial Doppler with the breath-holding method. The mean breath-holding index of the bilateral middle cerebral arteries (MCA-BHI) was square root transformed and analyzed with univariate and multivariate logistic regression models to determine its association with the highest tertiles of deep WMH burden (number and volume).

RESULTS

A low MCA-BHI was independently associated with the highest tertile of deep WMH number in patients with migraine (adjusted odds ratio [OR] 0.02, 95% confidence interval [CI] 0.0007-0.63, p = 0.026). In controls, the MCA-BHI was not associated with deep WMH number. Interaction analysis revealed that migraine modified the effect of MCA-BHI on deep WMH number (p for interaction = 0.029). The MCA-BHI was not associated with increased deep WMH volume in both patients and controls. Age was independently associated with deep WMH volume in patients (adjusted OR 1.07, 95% CI 1.004-1.15, p = 0.037).

CONCLUSIONS

In this study, we found a migraine-specific association between a reduced CVR to apnea and increased number of deep WMHs in healthy, nonelderly patients with migraine. A dysfunctional vascular response to apnea may predispose migraineurs to an increased risk of WMHs.

Classification of the glioma grading using radiomics analysis

Background

Grading of gliomas is critical information related to prognosis and survival. We aimed to apply a radiomics approach using various machine learning classifiers to determine the glioma grading.

Methods

We considered 285 (high grade n = 210, low grade n = 75) cases obtained from the Brain Tumor Segmentation 2017 Challenge. Manual annotations of enhancing tumors, non-enhancing tumors, necrosis, and edema were provided by the database. Each case was multi-modal with T1-weighted, T1-contrast enhanced, T2-weighted, and FLAIR images. A five-fold cross validation was adopted to separate the training and test data. A total of 468 radiomics features were calculated for three types of regions of interest. The minimum redundancy maximum relevance algorithm was used to select features useful for classifying glioma grades in the training cohort. The selected features were used to build three classifier models of logistics, support vector machines, and random forest classifiers. The classification performance of the models was measured in the training cohort using accuracy, sensitivity, specificity, and area under the curve (AUC) of the receiver operating characteristic curve. The trained classifier models were applied to the test cohort.

Results

Five significant features were selected for the machine learning classifiers and the three classifiers showed an average AUC of 0.9400 for training cohorts and 0.9030 (logistic regression 0.9010, support vector machine 0.8866, and random forest 0.9213) for test cohorts.

Discussion

Glioma grading could be accurately determined using machine learning and feature selection techniques in conjunction with a radiomics approach. The results of our study might contribute to high-throughput computer aided diagnosis system for gliomas.

Structural and Functional Brain Connectivity Changes Between People With Abdominal and Non-abdominal Obesity and Their Association With Behaviors of Eating Disorders

Abdominal obesity is important for understanding obesity, which is a worldwide medical problem. We explored structural and functional brain differences in people with abdominal and non-abdominal obesity by using multimodal neuroimaging and up-to-date analysis methods. A total of 274 overweight people, whose body mass index exceeded 25, were enrolled in this study. Participants were divided into abdominal and non-abdominal obesity groups using a waist–hip ratio threshold of 0.9 for males and 0.85 for females. Structural and functional brain differences were assessed with diffusion tensor imaging and resting-state functional magnetic resonance imaging. Centrality measures were computed from structural fiber tractography, and static and dynamic functional connectivity matrices. Significant inter-group differences in structural and functional connectivity were found using degree centrality (DC) values. The associations between the DC values of the identified regions/networks and behaviors of eating disorder scores were explored. The highest association was achieved by combining DC values of the cerebral peduncle, anterior corona radiata, posterior corona radiata (from structural connectivity), frontoparietal network (from static connectivity), and executive control network (from dynamic connectivity) compared to the use of structural or functional connectivity only. Our results demonstrated the effectiveness of multimodal imaging data and found brain regions or networks that may be responsible for behaviors of eating disorders in people with abdominal obesity.

Predicting Survival Using Pretreatment CT for Patients With Hepatocellular Carcinoma Treated With Transarterial Chemoembolization: Comparison of Models Using Radiomics

OBJECTIVE

The purpose of this study was to investigate the use of radiomics features as prognostic biomarkers for predicting the survival of patients treated with transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

We retrospectively analyzed 88 patients with HCC treated with TACE. High-dimensional quantitative feature analysis was applied to extract 116 radiomics features of pretreatment CT. A radiomics score model was constructed from these features with the use of least absolute shrinkage and selection operator Cox regression. A clinical score model was constructed from clinical variables with the use of multivariate Cox regression. A combined score model was constructed using the radiomics and clinical models. We compared the three models (the radiomics score, clinical score, and combined score models) for predicting overall survival, using Kaplan-Meier analysis and the log-rank test.

RESULTS

The following radiomics features were selected for the radiomics score model: histogram-based features (median, kurtosis, and energy), shape-based features (spherical disproportion and surface-to-volume ratio), gray-level co-occurrence matrix (GLCM)-based features (energy, informational measure of correlation, maximum probability, contrast, and sum average), and intensity size zone matrix-based features (size zone variability). For the clinical score model, the Child-Pugh score, α-fetoprotein level, and HCC size were included. The combined score model included five radiomics features (surface area-to-volume ratio, kurtosis, median, gray-level co-occurrence matrix contrast, and size zone variability) and three clinical factors (Child-Pugh score, α-fetoprotein level, and HCC size). The combined model was a better predictor of survival (hazard ratio, 19.88; p < 0.0001) than the clinical score model or the radiomics score model.

CONCLUSION

A radiomics approach combined with conventional clinical variables could be effective in predicting the survival of patients with HCC treated with TACE.

Clustering approach to identify intratumour heterogeneity combining FDG PET and diffusion-weighted MRI in lung adenocarcinoma

OBJECTIVES

Malignant tumours consist of biologically heterogeneous components; identifying and stratifying those various subregions is an important research topic. We aimed to show the effectiveness of an intratumour partitioning method using clustering to identify highly aggressive tumour subregions, determining prognosis based on pre-treatment PET and DWI in stage IV lung adenocarcinoma.

METHODS

Eighteen patients who underwent both baseline PET and DWI were recruited. Pre-treatment imaging of SUV and ADC values were used to form intensity vectors within manually specified ROIs. We applied k-means clustering to intensity vectors to yield distinct subregions, then chose the subregion that best matched the criteria for high SUV and low ADC to identify tumour subregions with high aggressiveness. We stratified patients into high- and low-risk groups based on subregion volume with high aggressiveness and conducted survival analyses. This approach is referred to as the partitioning approach. For comparison, we computed tumour subregions with high aggressiveness without clustering and repeated the described procedure; this is referred to as the voxel-wise approach.

RESULTS

The partitioning approach led to high-risk (median SUVmax = 14.25 and median ADC = 1.26x10^-3 mm²/s) and low-risk (median SUVmax = 14.64 and median ADC = 1.09x10^-3 mm²/s) subgroups. Our partitioning approach identified significant differences in survival between high- and low-risk subgroups (hazard ratio, 4.062, 95% confidence interval, 1.21 - 13.58, p-value: 0.035). The voxel-wise approach did not identify significant differences in survival between high- and low-risk subgroups (p-value: 0.325).

CONCLUSION

Our partitioning approach identified intratumour subregions that were predictors of survival.

KEY POINTS

• Multimodal imaging of PET and DWI is useful for assessing intratumour heterogeneity. • Data-driven clustering identified subregions which might be highly aggressive for lung adenocarcinoma. • The data-driven partitioning results might be predictors of survival.

DEWS (DEep White matter hyperintensity Segmentation framework): A fully automated pipeline for detecting small deep white matter hyperintensities in migraineurs

Migraineurs show an increased load of white matter hyperintensities (WMHs) and more rapid deep WMH progression. Previous methods for WMH segmentation have limited efficacy to detect small deep WMHs. We developed a new fully automated detection pipeline, DEWS (DEep White matter hyperintensity Segmentation framework), for small and superficially-located deep WMHs. A total of 148 non-elderly subjects with migraine were included in this study. The pipeline consists of three components: 1) white matter (WM) extraction, 2) WMH detection, and 3) false positive reduction. In WM extraction, we adjusted the WM mask to re-assign misclassified WMHs back to WM using many sequential low-level image processing steps. In WMH detection, the potential WMH clusters were detected using an intensity based threshold and region growing approach. For false positive reduction, the detected WMH clusters were classified into final WMHs and non-WMHs using the random forest (RF) classifier. Size, texture, and multi-scale deep features were used to train the RF classifier. DEWS successfully detected small deep WMHs with a high positive predictive value (PPV) of 0.98 and true positive rate (TPR) of 0.70 in the training and test sets. Similar performance of PPV (0.96) and TPR (0.68) was attained in the validation set. DEWS showed a superior performance in comparison with other methods. Our proposed pipeline is freely available online to help the research community in quantifying deep WMHs in non-elderly adults.

Functional connectivity based parcellation of early visual cortices

Human brain can be divided into multiple brain regions based on anatomical and functional properties. Recent studies showed that resting-state connectivity can be utilized for parcellating brain regions and identifying their distinctive roles. In this study, we aimed to parcellate the primary and secondary visual cortices (V1 and V2) into several subregions based on functional connectivity and to examine the functional characteristics of each subregion. We used resting-state data from a research database and also acquired resting-state data with retinotopy results from a local site. The long-range connectivity profile and three different algorithms (i.e., K-means, Gaussian mixture model distribution, and Ward's clustering algorithms) were adopted for the parcellation. We compared the parcellation results within V1 and V2 with the eccentric map in retinotopy. We found that the boundaries between subregions within V1 and V2 were located in the parafovea, indicating that the anterior and posterior subregions within V1 and V2 corresponded to peripheral and central visual field representations, respectively. Next, we computed correlations between each subregion within V1 and V2 and intermediate and high-order regions in ventral and dorsal visual pathways. We found that the anterior subregions of V1 and V2 were strongly associated with regions in the dorsal stream (V3A and inferior parietal gyrus), whereas the posterior subregions of V1 and V2 were highly related to regions in the ventral stream (V4v and inferior temporal gyrus). Our findings suggest that the anterior and posterior subregions of V1 and V2, parcellated based on functional connectivity, may have distinct functional properties.

Dynamic functional connectivity analysis reveals improved association between brain networks and eating behaviors compared to static analysis

Uncontrollable eating behavior is highly associated with dysfunction in neurocognitive systems. We aimed to quantitatively link brain networks and eating behaviors based on dynamic functional connectivity analysis, which reflects temporal dynamics of brain networks. We used 62 resting-state functional magnetic resonance imaging data sets representing 31 healthy weight (HW) and 31 non-HW participants based on body mass index (BMI). Brain networks were defined using a data-driven group-independent component analysis and a dynamic connectivity analysis with a sliding window technique was applied. The network centrality parameters of the dynamic brain networks were extracted from each brain network and they were correlated to eating behavior and BMI scores. The network parameters of the executive control network showed a strong correlation with eating behavior and BMI scores only when a dynamic (p < 0.05), not static (p > 0.05), connectivity analysis was adopted. We demonstrated that dynamic connectivity analysis was more effective at linking brain networks and eating behaviors than static approach. We also confirmed that the executive control network was highly associated with eating behaviors.

Three-dimensional continuous max flow optimization-based serous retinal detachment segmentation in SD-OCT for central serous chorioretinopathy

Assessment of serous retinal detachment plays an important role in the diagnosis of central serous chorioretinopathy (CSC). In this paper, we propose an automatic, three-dimensional segmentation method to detect both neurosensory retinal detachment (NRD) and pigment epithelial detachment (PED) in spectral domain optical coherence tomography (SD-OCT) images. The proposed method involves constructing a probability map from training samples using random forest classification. The probability map is constructed from a linear combination of structural texture, intensity, and layer thickness information. Then, a continuous max flow optimization algorithm is applied to the probability map to segment the retinal detachment-associated fluid regions. Experimental results from 37 retinal SD-OCT volumes from cases of CSC demonstrate the proposed method can achieve a true positive volume fraction (TPVF), false positive volume fraction (FPVF), positive predicative value (PPV), and dice similarity coefficient (DSC) of 92.1%, 0.53%, 94.7%, and 93.3%, respectively, for NRD segmentation and 92.5%, 0.14%, 80.9%, and 84.6%, respectively, for PED segmentation. The proposed method can be an automatic tool to evaluate serous retinal detachment and has the potential to improve the clinical evaluation of CSC.

Autism Spectrum Disorder Related Functional Connectivity Changes in the Language Network in Children, Adolescents and Adults

Autism spectrum disorder (ASD) is a neurodevelopmental disability with global implication. Altered brain connectivity in the language network has frequently been reported in ASD patients using task-based functional magnetic resonance imaging (fMRI) compared to typically developing (TD) participants. Most of these studies have focused on a specific age group or mixed age groups with ASD. In the current study, we investigated age-related changes in functional connectivity related measure, degree centrality (DC), in the language network across three age groups with ASD (113 children, 113 adolescents and 103 adults) using resting-state fMRI data collected from the autism brain imaging data exchange repository. We identified regions with significant group-wise differences between ASD and TD groups for three age cohorts using DC based on graph theory. We found that both children and adolescents with ASD showed decreased DC in Broca's area compared to age-matched TD groups. Adults with ASD showed decreased DC in Wernicke's area compared to TD adults. We also observed increased DC in the left inferior parietal lobule (IPL) and left middle temporal gyrus (MTG) for children with ASD compared to TD children and for adults with ASD compared to TD adults, respectively. Overall, functional differences occurred in key language processing regions such as the left inferior frontal gyrus (IFG) and superior temporal gyrus (STG) related to language production and comprehension across three age cohorts. We explored correlations between DC values of our findings with autism diagnostic observation schedule (ADOS) scores related to severity of ASD symptoms in the ASD group. We found that DC values of the left IFG demonstrated negative correlations with ADOS scores in children and adolescents with ASD. The left STG showed significant negative correlations with ADOS scores in adults with ASD. These results might shed light on the language network regions that should be further explored for prognosis, diagnosis, and monitoring of ASD in three age groups.

Neuroimaging biomarkers to associate obesity and negative emotions

Obesity is a serious medical condition highly associated with health problems such as diabetes, hypertension, and stroke. Obesity is highly associated with negative emotional states, but the relationship between obesity and emotional states in terms of neuroimaging has not been fully explored. We obtained 196 emotion task functional magnetic resonance imaging (t-fMRI) from the Human Connectome Project database using a sampling scheme similar to a bootstrapping approach. Brain regions were specified by automated anatomical labeling atlas and the brain activity (z-statistics) of each brain region was correlated with body mass index (BMI) values. Regions with significant correlation were identified and the brain activity of the identified regions was correlated with emotion-related clinical scores. Hippocampus, amygdala, and inferior temporal gyrus consistently showed significant correlation between brain activity and BMI and only the brain activity in amygdala consistently showed significant negative correlation with fear-affect score. The brain activity in amygdala derived from t-fMRI might be good neuroimaging biomarker for explaining the relationship between obesity and a negative emotional state.

Parametric response mapping of dynamic CT: enhanced prediction of survival in hepatocellular carcinoma patients treated with transarterial chemoembolization

PURPOSE

The aim of this study was to evaluate the prognostic significance of parametric response mapping (PRM) analysis for hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE).

METHODS

We recruited 65 HCC patients who underwent TACE. These patients underwent longitudinal multiphasic CT before and after TACE. We applied PRM analysis to the baseline CT before TACE and first/second follow-up CTs. The results of PRM analyses were used to stratify patients into responders and non-responders. Overall survival was compared between the two groups. An independent survival analysis using conventional radiological assessments was performed, and the results were compared with PRM results. Univariate and multivariate analyses were performed to identify clinical factors affecting survival.

RESULTS

The PRM analyses demonstrated that the responding group had a median survival of 529 days, while the non-responding group had a median survival of 263 days [hazard ratio (HR) 12.9, p < 0.05 for differences in survival]. The manual analyses indicated median survivals of 491 and 329 days for the responding and non-responding groups, respectively (HR 2.7, p < 0.05). Tumor size, albumin level, and PRM values were found to be significantly related to overall survival after univariate and multivariate analyses.

CONCLUSIONS

The PRM analysis could be a better predictor of overall survival for patients with HCC undergoing TACE than conventional radiological assessments.

Imaging genetics approach to Parkinson's disease and its correlation with clinical score

Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with both underlying genetic factors and neuroimaging findings. Existing neuroimaging studies related to the genome in PD have mostly focused on certain candidate genes. The aim of our study was to construct a linear regression model using both genetic and neuroimaging features to better predict clinical scores compared to conventional approaches. We obtained neuroimaging and DNA genotyping data from a research database. Connectivity analysis was applied to identify neuroimaging features that could differentiate between healthy control (HC) and PD groups. A joint analysis of genetic and imaging information known as imaging genetics was applied to investigate genetic variants. We then compared the utility of combining different genetic variants and neuroimaging features for predicting the Movement Disorder Society-sponsored unified Parkinson's disease rating scale (MDS-UPDRS) in a regression framework. The associative cortex, motor cortex, thalamus, and pallidum showed significantly different connectivity between the HC and PD groups. Imaging genetics analysis identified PARK2, PARK7, HtrA2, GIGYRF2, and SNCA as genetic variants that are significantly associated with imaging phenotypes. A linear regression model combining genetic and neuroimaging features predicted the MDS-UPDRS with lower error and higher correlation with the actual MDS-UPDRS compared to other models using only genetic or neuroimaging information alone.